Provider Demographics
NPI:1588855795
Name:FOTI, GREGORY P (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:P
Last Name:FOTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2140 PEACHTREE RD NW
Mailing Address - Street 2:SUITE 232
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1314
Mailing Address - Country:US
Mailing Address - Phone:404-231-4431
Mailing Address - Fax:404-231-5677
Practice Address - Street 1:1040 PARK AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5633
Practice Address - Country:US
Practice Address - Phone:404-231-4431
Practice Address - Fax:404-231-5677
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD432186207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102040859 0001Medicaid
PA1637180OtherAETNA HMO (HFC)
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA606685OtherHEALTH AMERICA
PA120420410OtherDEPT OF LABOR
PA1710041OtherAETNA HMO (WH)
PA2166787OtherMAMSI
PA25-1716306OtherFIRST HEALTH
PA25-1716306OtherGREATWEST
PA50071074OtherCAPITAL BLUECROSS (HFC)
PA25-1716306OtherDEVON
PAG920-0066/25RXCUOtherCAREFIRST
PA223009OtherUNISON
PA50087504OtherCAPITAL BLUECROSS (WH)
PA25-1716306OtherINTERGROUP
PA867633OtherMEDICARE GROUP #
PAP00432904OtherRAILROAD MEDICARE
PA25-1716306OtherINFORMED
PA25-1716306OtherHEALTHNET/TRICARE
PA1569482OtherGATEWAY
PA25-1716306OtherMULTIPLAN/PHCS
PA9234069OtherAETNA NON-HMO
PAFO1979863OtherHIGHMARK BLUE SHIELD
PAMD432186OtherLICENSE
PAMD432186OtherLICENSE
PA120420410OtherDEPT OF LABOR